Saraceno B, Tognoni G
Psychiatry Unit, Istituto di Richerche Farmacologiche Mario Negri, Milano, Italy.
Int J Soc Psychiatry. 1989 Spring;35(1):98-109. doi: 10.1177/002076408903500111.
One of the main reasons why the Italian experience has been the object of much controversial attention in the international literature over the last decade lies in the ambiguity of the terms of reference used. Methodologically, it is of critical importance to re-establish the permanent dialectical relationship between the reality of the Italian experience, the prescription of the Law, and the administration of the reform. In this context, the evaluative variables are less the 'process' indicators of implementation of the reform, and more the qualitative 'outcome' assessment of the fate of the policy. The following concepts are discussed in detail, both in relation to Italy and to the broader status of psychiatry: de-Institutionalisation and de-hospitalisation; psychiatric hospital; rehabilitation-Home; Service-Services-Intervention; User; primary health care; evaluative research.
在过去十年里，意大利的经验成为国际文献中备受争议关注的对象，其主要原因之一在于所使用的参考术语含混不清。从方法论角度来看，重新确立意大利经验的现实、法律规定与改革实施之间永久的辩证关系至关重要。在这种背景下，评估变量与其说是改革实施的“过程”指标，不如说是政策命运的定性“结果”评估。以下概念将结合意大利以及更广泛的精神病学状况进行详细讨论：去机构化和去住院化；精神病医院；康复之家；服务-服务-干预；使用者；初级卫生保健；评估研究。
